| NPI | 1194778159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 37593) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MA 37593) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2008-08-12 |